Laserfiche WebLink
' � .J . <br /> f)_`-� ` , ��' _ � _ ''' CHART N0. �� �` <br /> i everett (�J�C� � l�'`) � ! <br /> I �s�� <br /> � <br /> � � <br />� I City of Everett l�/z 3� ��j,� i <br />� / <br /> Sewer Application and Permit �� <br />� N0. GZH6 / �O DATE �� —� ' �_g <br /> /- 7�. �. � � �-- �.�. <br />� Service Address_�� ��n-r� ==Ga�-�'�"� Utility Account No. <br />` �/ O% <br />( Billing Address_��� f`�� �� ��' Permit Fee �Q <br />� I <br /> City, State, Zip�q,�?ats��l� • ��a°3 Connection Charge�s) <br />� v <br /> Owner (Mortgagor) Total Fee 7'� I <br /> r Billing Name / <br /> � <br />� Connection By I <br />� Address Signed � <br /> Cusmmcr <br /> I` � <br /> r Phone ' <br />� II <br />` DESCRIPTION: Sewer Di,Vict - I <br />� Lot lock� <br /> � Monthly Sewer Service � <br />� Plat i <br />� Monthl Sewer Constr. <br />� Unplatted Description V i <br /> f - Trunk ' <br />, TYPe Permii: � <br />� - Lateral _ <br /> i I <br /> l <br /> , Remarks: <br />� Abutting Lot Line <br />` N, S, E, W_,�Co t,� ft. <br /> h <br />� � � <br />, Approved B - I <br /> Ciry Engineer ' <br />� Issued By� I, <br />, � I' <br />; Inspection By � - ` ~` <br /> Date I nspected 9 ��1--�� <br />, SEE SKETCH ATTACHED N�• �2�67 II <br />' I � <br /> INSPECTION � <br /> '�. <br />. <br />